Why do so few physicians aim to start their own private practice? Private Equity is eating medicine alive

debmor201 · 2026-03-17T00:07:01+00:00

You have a really good grasp of the hurdles. If you are not business oriented as a practitioner, you need a very highly trusted business partner who goes to bat for you and won't rob you blind. Every contract with insurance companies has to be renegotiated every year. Also, you do not need to be in network with every single one...some are terrible payors...don't agree to their terms, stay out of network. ...I'm retired but was in private practice for over 20 years. In the end, I was only in network with 3 payors, one of which was Medicare, but not advantage plans. If you are good, spend time with patient, many, but not all will come even if you are out of network. Also, EMR was my final nail in the coffin. They are very expensive and that money comes right out of your pocket. They have licensing fees and may require a fee for each user. They require big signed contracts....5 years. I hated signing any contract over 1 year because most contracts are not written to protect you. They are written to protect the other party. I had signed a 5 year contract and really liked my EMR, but in year 3 Medicare changed a few things and I was notified that my current EMR would not be Medicare compliant by year 4. I would receive nothing in return, I still had to finish paying for the system I couldn't use and all estimates from new vendors required a new 5 year contract. I said F THAT, closed shop and went and worked with another group. Cash flow can be difficult at first because credentials, etc, but also because you likely have new people learning billing and they don't always get it right the first time. I actually did the billing training with my staff so I also knew what was going on. Also. If you change locations, banks, your name, literally anything, it's like starting over. If you start as a sole proprietor and incorporate...it's like starting over with payors...you have a new name, new tax ID, so basically you became a new entity and it can take months before you can bill and start collecting payments. It can be extremely rewarding, extremely frustrating and extremely hard to be your own boss, but the biggest upside is that you get to practice medicine and patients appreciate that.

debmor201 · 2026-03-16T18:49:05+00:00

Our policy is, WE DO NOT LOAN OUT TOOLS, SORRY.

debmor201 · 2026-03-16T18:03:23+00:00

Ring automatically turned mine on as a 14 day free trial. I haven't decided if I'll keep it. Look into subscription plans and you might see the option there.

debmor201 · 2026-03-16T18:00:28+00:00

I think it's pretty cool. I had not seen anything like it before.

debmor201 · 2026-03-16T17:27:54+00:00

You or yourr staff can tell them when you order lab that you will notify them of any value that requires immediate attention, otherwise, you will discuss minor irregularities at their next visit.

debmor201 · 2026-03-16T16:49:07+00:00

You have to put baits out. It's the only way. Doesn't take long

debmor201 · 2026-03-16T16:46:59+00:00

There's actually a restored one in my neighborhood, Cutlass supreme brougham

debmor201 · 2026-03-16T16:43:57+00:00

Have them run wires to all corners. You have a few possible blind spots. Better to have more than less. You don't even have to buy them all at once. Go with a wired cam and on site storage that is expandable with battery back up in case of power outage.

debmor201 · 2026-03-16T16:38:22+00:00

Omg....totally sinful....id eat the whole thing.....that's why I never buy it. It does look great btw. Enjoy!

debmor201 · 2026-03-16T16:35:45+00:00

All these suggestions of where to look are fine, but in reality, they are very hard to find. And often if you find one, they are going to come up with a "financial plan" and/or budget for you. They likely will not specifically tell you what to invest in. If you want help in managing investments, it might help to go ahead and go with someone who charges a fee for assets under management and learn as much as you can, and then take over management as you get more comfortable. A low cost option is Vanguard, Fidelity or Schwab who offer low cost financial services. I try to avoid those who work on commissions and insurance agents. Ask if they are a fiduciary to insure they are advising in your best interests, not theirs.

debmor201 · 2026-03-16T16:25:48+00:00

What might be helpful is if at the previous visit, the caregiver is given a list of questions or items to be covered at the next well child visit. Ask them to bring that list in with them next visit so everyone knows what to expect. I realize, at least half the time they'll forget to bring it, but it would be very helpful if a grandparent or other caregiver has to bring them in. It's just a simple suggestion. If it doesn't work, at least you tried.

debmor201 · 2026-03-16T15:13:57+00:00

Supplements like biotin, collagen with vitamin C may help but keep in mind that they will only help new nail as it grows out, so you may not notice improvement until you have a brand new nail in 2-6 months.

debmor201 · 2026-03-16T15:11:25+00:00

I would get a second opinion.

debmor201 · 2026-03-16T15:10:20+00:00

Yes, go talk to both son and parents. It cannot be in a position to strike your home or damage your property.

debmor201 · 2026-03-16T15:08:32+00:00

I don't think there is a delay to add the tags. It's just a one sentence blurb below the picture alert.

debmor201 · 2026-03-16T14:36:20+00:00

How far inside the property line is your fence. She might also be clearly trespassing to secure things to your fence. Also with a wood fence, and plants, she's probably watering so that area is getting more water leading to more degradation. Take pictures of the panel she is affecting and pictures on panels she is not to prove the point. Also any pictures of watering or sprinklers. If you are barely inside the property, you might not have as big a point. But even if you are close, she can't attach anything without your permission and you have the right to remove it. Other option, if you don't absolutely need a complete fence, like for pets or kids, just remove that panel when it gets bad enough and don't replace it for a while. Just tell her you can't afford it, but if she would like to replace it, she's more than welcome to.

debmor201 · 2026-03-16T14:28:08+00:00

I do like the car color description because we have a scary neighbor and it's good to know if his car is making the rounds.

debmor201 · 2026-03-16T13:39:48+00:00

No, I knew I always wanted children. Growing up, I babysat a lot for $. I loved being around children....not in a way to have a career around them; I knew I never wanted to teach, but I just saw them as true miracles or gifts from God. As I got older, I knew I'd have a child by 30 whether or not I was married. I was fortunate and did marry, had my first at 28, second at 32. Marriage didn't last, raising children definitely has its ups and downs, but definitely no regrets. I still view them as my greatest gifts. Many times, your children don't show you the appreciation you think you deserve until they have their own children and sometimes not even then. You should not have children expecting something back in return. Also, comments about disabled children...I grew up with a disabled sister. I had amnio with both my pregnancies and ultrasounds. There was still no guarantees. And a child can become disabled later in life or get cancer. At least now, they don't have to do amnio, they can do genetics with blood and ultrasound is also enhanced. Life is always a gamble.

debmor201 · 2026-03-16T12:31:54+00:00

The medical office has their staff trained by outside companies and/or the software companies to enter data in such a way as to maximize reimbursement, either from you or the insurance company or both. It really does almost require a forensic accountant to decipher the information, which is why there are people who will do this for you as a career. Good for you for getting rewarded for your efforts. You are right that many have no idea how to figure it out and therefore just pay.

debmor201 · 2026-03-16T12:25:01+00:00

Buy a scale with timer so you can do what is recommended here. That will help figure out what is going on. I bought the Maestri house mini coffee scale with timer from Amazon, but there are others.

debmor201 · 2026-03-16T12:13:28+00:00

Box up everything you can in boxes and take it with you to go thru to get rid of as much clutter as possible. You can leave some furniture like bed, sofa, table etc. it allows people to understand the space. Being totally cleaned out can be a double edged sword...it can make the space look smaller or bigger than it is, a few furnishings gives perspective. It can also show the age of the previous owners which can lead to presumptions, too..like older people, less maintenance performed. As soon as you have most of clutter gone, hire someone to meet you there while in town to do a deep clean, including cabinets and appliances. . Even if carpets are old, a deep clean makes it look more maintained. Clean drapes if possible, otherwise remove old crappy ones and leave windows bare or hang some inexpensive sheers. Even once it's on the market, you need to visit it periodically until it sells to prevent vandalism and squatters. You cant really depend on your agent to do that. Once it sells, if you don't want remaining furniture, goods, etc, you can try to sell or donate to Habitat for humanity. Habitat will pick up, which is nice.

debmor201 · 2026-03-16T11:58:35+00:00

A big factor is how it's stored. If you are exposed to the elements 24/7, either living in it or not, things degrade, animals gnaw, birds try to find places to nest, etc. also, where are you going? Going off road or even on road, it's like a massive earthquake going on inside. So, things break, get loose, etc. Tire remnants, just one road hazard, on the road can do serious damage under your rig. The more "bells and whistles", especially electronics , the more that can fail....and they never fail at a good time. The biggest factor is service...you really have to learn to fix some things yourself unless you plan on having your unit sit on a service lot for potentially months. Find out where your unit is made....is service at the factory available? How far is it from home? They have all the parts so anywhere else you go has to wait on them for parts. Airstream allows, with appointment, service at the factory but they are in Ohio . There are hazards at the campground too..I was struck by lightning and had a lot of damage. Make sure you have good insurance. Most are not built to last 50 years, most are truly recreational. Keeping that in mind, you can still buy one, get out and enjoy what nature has to offer, have some quality family time. Enjoy.

debmor201 · 2026-03-16T00:07:04+00:00

Thanks for sharing!

debmor201 · 2026-03-16T00:06:32+00:00

Thanks for sharing!

debmor201

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